抗-HBs阳性隐匿性乙型肝炎病毒携带者血液在两名输血受者中具有传染性。
Anti-HBs positive occult hepatitis B virus carrier blood infectious in two transfusion recipients.
作者信息
Levicnik-Stezinar Snezna, Rahne-Potokar Urska, Candotti Daniel, Lelie Nico, Allain Jean-Pierre
机构信息
Blood Transfusion Center of Slovenia, Ljubljana, Slovenia.
出版信息
J Hepatol. 2008 Jun;48(6):1022-5. doi: 10.1016/j.jhep.2008.02.016. Epub 2008 Mar 28.
BACKGROUND/AIMS: Occult hepatitis B infection (OBI) in blood donations is not considered infectious when anti-HBs is present.
METHODS
Four months after transfusion of eight blood components during coronary arterial bypass surgery, a 59-year-old patient developed acute hepatitis B. A second 71-year-old patient transfused with a red cell concentrate (RCC) from one of these donations had early HBV infection 7 months post-transfusion. Samples were tested for HBV serological markers and HBV DNA was quantified and sequenced.
RESULTS
One implicated donation contained anti-HBc, anti-HBs (12 IU/L) and 180 IU/ml of HBV DNA. Previous and subsequent samples contained 3-10 times lower viral load and slightly variable anti-HBs. Two previous donations did not cause HBV infection. Recipients of the FFP and RCC from the index donation were both HBV infected and carried genotype D strains with sequences identical to the donor strain.
CONCLUSIONS
Despite anti-HBs, an OBI carrier transmitted HBV to two immunocompetent transfusion recipients.
背景/目的：当存在抗-HBs时，献血中的隐匿性乙型肝炎感染（OBI）不被视为具有传染性。
方法
一名59岁患者在冠状动脉搭桥手术期间输注8个血液成分4个月后发生急性乙型肝炎。另一名71岁患者输注了来自其中一份献血的红细胞浓缩液（RCC），输血后7个月发生早期HBV感染。对样本进行HBV血清学标志物检测，并对HBV DNA进行定量和测序。
结果
一份有问题的献血中含有抗-HBc、抗-HBs（12 IU/L）和180 IU/ml的HBV DNA。之前和之后的样本病毒载量低3至10倍，抗-HBs略有变化。之前的两份献血未导致HBV感染。来自该份有问题献血的新鲜冰冻血浆（FFP）和RCC的接受者均感染了HBV，并携带与供体菌株序列相同的D基因型菌株。
结论
尽管存在抗-HBs，但一名OBI携带者将HBV传播给了两名免疫功能正常的输血接受者。
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